Metastasis from metastasis -- Bizarre route of a metastatic cell : Case reports and Review of literature
Main Article Content
Keywords
Renal cell carcinoma; Lung metastasis; Gastric cancer; Breast metastasis; Metastasectomy; Lymph node metastasis (LNM); Lymph node involvement (LNI)
Abstract
In cancer biology, Metastasis is one of the most important hallmarks of tumour progression. Cancer cells undergo a series of genetic mutations in order to acquire invasive characteristics that allow them to spread to secondary sites and become a metastatic foci. These tumour cells from the metastatic focus again undergoing genetic mutations and spreading to another site is a rare phenomenon. We report two such cases with a rare phenomenon of metastasis arising from the metastatic focus i.e, patients with metastatic renal cell carcinoma and gastric carcinoma respectively.
References
[2] Welch DR, Hurst DR. Defining the hallmarks of metastasis. Cancer Research. 2019; 79: 3011–3027.
[3] Koscielny S, Tubiana M. Parallel progression of tumour and metastases. Nature Reviews Cancer. 2010; 10: 156.
[4] Renaud S, Falcoz PE, Olland A, Massard G. Should mediastinal lymphadenectomy be performed during lung metastasectomy of renal cell carcinoma? Interactive CardioVascular and Thoracic Surgery. 2013; 16: 525–528.
[5] Iesato A, Oba T, Ono M, Hanamura T, Watanabe T, Ito T, et al. Breast metastases of gastric signet-ring cell carcinoma: a report of two cases and review of the literature. OncoTargets and Therapy. 2014; 8: 91–97.
[6] Lordick F, Carneiro F, Cascinu S, Fleitas T, Haustermans K, Piessen G, et al. Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2022; 33: 1005–1020.
[7] Ding J, Gu H, Yang Z, Lu Y, Guo G. Breast metastasis from lung adenocarcinoma: a case report and review of the literature. Frontiers in Oncology. 2024; 14: 1370453.
[8] Ma Y, Liu W, Li J, Xu Y, Wang H. Gastric cancer with breast metastasis: clinical features and prognostic factors. Oncology Letters. 2018; 16: 5565–5574.
[9] Winter H, Meimarakis G, Angele MK, Hummel M, Staehler M, Hoffmann RT, et al. Tumor infiltrated hilar and mediastinal lymph nodes are an independent prognostic factor for decreased survival after pulmonary metastasectomy in patients with renal cell carcinoma. Journal of Urology. 2010; 184: 1888–1894.
[10] Murthy SC, Kim K, Rice TW, Rajeswaran J, Bukowski R, DeCamp MM, et al. Can we predict long-term survival after pulmonary metastasectomy for renal cell carcinoma? The Annals of Thoracic Surgery. 2005; 79: 996–1003.
[11] Pfannschmidt J, Hoffmann H, Muley T, Krysa S, Trainer C, Dienemann H. Prognostic factors for survival after pulmonary resection of metastatic renal cell carcinoma. The Annals of Thoracic Surgery. 2002; 74: 1653–1657.
[12] Assouad J, Petkova B, Berna P, Dujon A, Foucault C, Riquet M. Renal cell carcinoma lung metastases surgery: pathologic findings and prognostic factors. The Annals of Thoracic Surgery. 2007; 84: 1114–1120.
[13] Meimarakis G, Angele M, Staehler M, Clevert DA, Crispin A, Rüttinger D, et al. Evaluation of a new prognostic score (Munich score) to predict long-term survival after resection of pulmonary renal cell carcinoma metastases. American Journal of Surgery. 2011; 202: 158–167.
[14] National Cancer Institute. Renal cell cancer treatment (PDQ®)–health professional version. 2025. Available at: https://www.cancer.gov/types/kidney/hp/kidney-treatment-pdq (Accessed: 21 October 2025).
[15] Bendimya M, Kairouani M, El Magroud M, Bennani A, Al Jarroudi O, Brahmi SA, et al. Unusual metastasis of gastric signet ring cell carcinoma to the breast: a case report of a young Moroccan patient. Cureus. 2024; 16: e56333.
[16] Khalayleh H, Bader R, Imam A, Khoury D, Yosepovich A, Bar-Zakai B, et al. Gastric cancer metastases to the breast: systemic review and meta-analysis of the English literature. Chirurgia. 2023; 36: 261–269.
[17] Buerba-Vieregge HH, Fernández-Ferreira R, Soberanis-Piña PD, De la Peña-López IR, Navarro-García LM, Macari-Jorge A. Breast metastasis of gastric signet ring cell carcinoma: a case report and literature review. Case Reports in Oncology. 2021; 14: 165–172.
[18] Ajani JA, D’Amico TA, Bentrem DJ, Chao J, Cooke D, Corvera C, et al. Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2022; 20: 167–192.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Mohammed Sameer, Department of Surgical Services, Regional Cancer Centre, 695011 Thiruvananthapuram, India
M.ch Surgical Oncology Senior Resident, Department of Surgical Services, Regional Cancer Centre, Thiruvananthapuram, Kerala - 695011, IND
Vipul Goyal, Department of Surgical Services, Regional Cancer Centre, 695011 Thiruvananthapuram, India
M.ch Surgical Oncology Senior Resident, Department of Surgical Services, Regional Cancer Centre, Thiruvananthapuram, Kerala - 695011, IND
Madhu Muralee, Department of Surgical Services, Regional Cancer Centre, 695011 Thiruvananthapuram, India
Professor, Department of Surgical Services, Regional Cancer Centre, Thiruvananthapuram, Kerala - 695011, IND